Safety and Efficacy of Sofosbuvir and Daclatasvir in The Treatment of Chronic HCV Infection in Elderly Egyptian Patients

Background: Chronic Hepatitis-C virus [HCV] infection is endemic in Egypt, with the highest prevalence worldwide. There are few studies on the effectiveness and safety of direct acting antivirals in treating geriatric patients with chronic HCV. Aim of the work: This study aimed to determine the efficacy and safety of sofosbuvir and daclatasvir with or without ribavirin in treating chronic HCV infection in geriatric Egyptian patients. Patients and Methods: In this study, we analyzed the medical files of 100 patients with chronic HCV, ≥ 65 years old, naïve, and eligible for HCV treatment. Patients were classified into: Group I; 50 patients without cirrhosis and Group II; 50 patients with Cirrhosis. All patients were subjected to history taking, clinical and laboratory evaluation. Electrocardiogram [ECG] and echocardiography were also conducted. Polymerase chain reaction [PCR] for HCV- ribonucleic acid [RNA] was performed and compared between groups at baseline, at the end of treatment, and at 12 weeks later. All patients underwent an abdominal ultrasound and fibrosis-4 [FIB-4] score. Group I was treated with sofosbuvir 400 mg and daclatasvir 60 mg once daily for 12 weeks, while weight-based ribavirin was added in group II. Results: Overall, 95 patients achieved sustained virological response[SVR]-12, three had failed treatment, and two had relapse. There were no significant differences in treatment success between the groups after treatment completion [HCV RNA was below the detection limit in 49 patients in group I and 48 patients in group II] and 12 weeks later [HCV RNA was below the detection limit in 48 patients in group I and 47 patients in group II], with one patient in group I and two patients in group II had failed treatment. There was also a significant decrease in alanine transaminase [ALT] and aspartate transaminase [AST] in both groups after treatment completion. Some patient symptoms like easy fatigability and dyspepsia have been improved with no significant cardiac changes after therapy. Conclusions: Sofosbuvir and daclatasvir with or without ribavirin are safe and effective in treating elderly Egyptian patients with chronic HCV infection.